Estonia faces growing family doctor shortage with no easy fix

More than 110,000 people in Estonia are on patient lists without a permanent family doctor, and far more doctors are expected to retire in the coming years than will graduate from residency, ERR reports.

A recent analysis by the State Audit Office found that 110,700 people lack a permanent family doctor, up from 72,500 four years ago. Family Doctors’ Association head Elle-Mall Sadrak said qualified doctors are in the system but are not always working where they are most needed. About 900 doctors with family medicine qualifications serve around 780 patient lists, she said.

Sadrak said a bill being considered by parliament could introduce special measures for risk and crisis areas. These might include more flexible work arrangements, such as allowing doctors to work remotely part of the time or be physically present three or four days a week rather than five.

She also called for safeguards against excessive workloads and stress, including a way to remove patients who are mentally or physically abusive towards doctors from a doctor’s list. Some family doctors have left their jobs because of patients who harassed them, she said.

Social Affairs Minister and family doctor Karmen Joller said the shortage reflects earlier delays in increasing training numbers. A record 46 family medicine residents were accepted this year, but training takes four years, so it will not provide a quick solution.

Doctors’ Union head Katrin Rehemaa said some newly trained family doctors choose to work in private medicine rather than take on a patient list. She said the system should give them enough incentive to take one. Joller said that working in private medicine does not necessarily mean young doctors are leaving the public family medicine system, and noted that many take several years to settle into their careers before choosing a practice.